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Semin Thromb Hemost 2016; 42(06): 612-621
DOI: 10.1055/s-0036-1584133
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Monitoring of Hemostasis and Management of Anticoagulant Thromboprophylaxis in Pregnant Women with Increased Risk of Fetal Loss

Lucia Stanciakova
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Miroslava Dobrotova
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Zuzana Jedinakova
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
2   Center of Hemostasis and Thrombosis, HEMO MEDIKA spol. s r.o., Martin, Slovak Republic
,
Lukas Duraj
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Ingrid Skornova
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Lubica Korinkova
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Pavol Holly
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Jan Danko
3   Clinic of Gynecology and Obstetrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovak Republic
,
Jan Stasko
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
,
Peter Kubisz
1   National Center of Hemostasis and Thrombosis, Clinic of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin University Hospital, Martin, Slovak Republic
› Author Affiliations
Further Information

Publication History

Publication Date:
06 June 2016 (online)

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Abstract

Physiological prothrombotic changes during pregnancy and the postpartum period, along with other preexisting maternal risk factors, increase the risk of both venous thromboembolism (VTE) and adverse pregnancy outcomes. Pregnancy complications that develop due to placental insufficiency as a result of inappropriate activation of coagulation are present in more than 5% of pregnancies and can contribute to significant maternal morbidity and mortality. Therefore, anticoagulant prophylaxis in women with congenital and acquired thrombophilic conditions should be actively considered. According to the Guidelines of American College of Chest Physicians, the use of low-molecular-weight heparin is suggested for prophylaxis of VTE and pregnancy complications in high-risk pregnant women. However, personalized refinements of such thromboprophylaxis remains unspecified, despite the necessity of better targeted recommendations for life-threatening conditions. We, therefore, review the possibilities of longitudinal monitoring and comprehensive assessment of changes in hemostasis in the group of high-risk pregnant women, which can then be used for early prediction and individualization of the optimal anticoagulant thromboprophylaxis of pregnancy complications. Simultaneously, we present our single-center experience with such monitoring and our first series of results.

Keywords

high-risk pregnancy - fetal loss - anticoagulant prevention - monitoring of hemostasis - thrombosis
 

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